Organization Active NPI

Choudrant Primary Care LLC

  • Rural Health Clinic/Center
  • Choudrant, LA
National Provider Identifier
1962267922
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
CHOUDRANT PRIMARY CARE LLC
Practice address
3845 Elm St Ste 3
Choudrant, LA 71227-3017
Phone
(318) 695-9200
NPI assigned
Feb 19, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Jennifer S. Juneau, APRN, CNPNPI 1285981068
Title
Owner
Phone
(318) 695-9200

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X Primary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X

Addresses

Primary practice location

3845 Elm St Ste 3
Choudrant, LA 71227-3017

Mailing address

216 Loblolly LN
Choudrant, LA 71227-4804

Other names 1

  • Choudrant Primary Care Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240308000368 LA Part B Supplier - Clinic/Group Practice 1052757416 Receives reassigned benefits from 2 practitioners
Practice locations: Choudrant, LA
O20241004002070 LA Part A Provider - Rural Health Clinic 1052757416 Practice locations: Choudrant, LA

Rural health clinic certification: CCN 198937

Legal name
CHOUDRANT PRIMARY CARE LLC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 29, 2025
Last certification
Dec 29, 2025
Ownership / control type
1B
Organization structure
LLCProprietary
Incorporated
Jan 23, 2024 in LA
Enrollment address
3845 Elm St
Ste 3
Choudrant, LA 71227-3017

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2303160Choudrant Primary Care LLC3845 Elm St, Suite 3, Choudrant, LA 71227Certificate of waiverApr 21, 2028

National Provider Directory

National Provider Directory

Locations

3845 Elm St
Ste 3
Choudrant, LA 71227
Phone (318) 695-9200

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/EBIHDD

Ownership & related parties

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Jennifer S Juneau Individual 5% Or Greater Direct Ownership Interest Sep 19, 2024 100%
W-2 Managing EmployeeOwner/Manager Sep 19, 2024 100%
Johnny Juneau Individual Operational/Managerial Control Sep 19, 2024 100%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1708300800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726790400000",
    "number": "1962267922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 LOBLOLLY LN",
            "city": "CHOUDRANT",
            "state": "LA",
            "postal_code": "712274804"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3845 ELM ST STE 3",
            "city": "CHOUDRANT",
            "state": "LA",
            "postal_code": "712273017",
            "telephone_number": "318-695-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHOUDRANT PRIMARY CARE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-19",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A",
        "authorized_official_last_name": "JUNEAU",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "S.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "318-695-9200",
        "authorized_official_credential": "APRN, CNP"
    },
    "taxonomies": [
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Choudrant Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Choudrant, LA

Sources for this page

Verify at the official NPI Registry.